The majority of local governments lack sufficient resources to respond effectively in an independent manner to a disaster or large-scale emergency. To achieve success, they must work closely with other organizations. The research problem is that regional emergency response relationships are not well understood, which could lead to ineffective or inefficient practices. The research purpose was to describe and analyze regional emergency response in Hampton Roads, Virginia. The research methodology involved a qualitative approach, utilizing interviews and archival research. Organizational leaders of the Hampton Roads Marine Incident Response Team and the Southside Tidewater Regional Hazardous Materials Response Team were interviewed to solicit their perspectives on the manner in which leadership, management and the environment influenced the development and sustenance of regional emergency response teams. Additionally, foundational documents for each team were studied to assess their influence on team administration. The research was based on collaboration theory. A research model identified as the model of regional emergency response was developed from the literature and used as a framework for the study. The findings suggest that regional emergency response teams may take very varied forms, customized to meet individual programmatic needs. These teams may be collaborative in nature, but are more likely to exhibit mixed characteristics, including those associated with coordination or cooperation. In contrast to collaborative endeavors associated with economic development, health care and education, which require the active engagement of the top tiers of an organization, regional emergency teams such as those studied here appear to be developed and operated at much lower levels of an organization, supported, only when needed, by the formal leadership of an organization. The findings also suggested there were four pre-conditions necessary for the development of regional emergency response teams structured to share resources, including the existence of a clear goal, the integration of cost-sharing mechanisms, strong support from individual organizations, and a strict focus on the strategic vision. The findings of this research may be used to encourage or facilitate the development of regional emergency response, thereby making regions better prepared for emergency incidents.